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1 Knowledge Brief How Well Is the Child Welfare System Serving Youths with? Child welfare systems were designed with a focus on ensuring the safety and stability of abused and neglected children. Today, though, these systems also serve as an alternative to secure confinement for juvenile offenders, who generally require behavioral health and rehabilitation services. The researchers view this as a potential mismatch between individual youth needs and professional capacity, and in this study they looked at the effects of the mismatch. They found that youths with behavioral problems experience more changes in placement and are placed in more restrictive settings, such as group homes and residential centers, rather than with foster families. They also found that youths placed entirely or in part because of behavior problems are at greater risk of subsequent arrest when compared with youths placed only for abuse or neglect. Since child welfare is often the only resource available to vulnerable families struggling with behavioral issues, they suggest improving the collaboration between child welfare and juvenile justice systems. Background The primary purpose of child welfare in the United States is to respond to the needs of abused and neglected children. Yet child welfare systems are often expected to serve youths who fall beyond this traditional scope. In New York City, for example, child welfare also serves youths involved with the juvenile justice system, offering evidence-based alternatives to secure confinement. Serving youths with behavioral health issues is not entirely new. Child welfare systems are routinely asked to address a wide range of mental health problems, and often these youths are placed in foster care and other residential programs. Estimates from the National Survey of Child and Adolescent Well-Being vary by location, but show that overall, 45 percent of children who are not removed from the biological family home, and 54 percent of those placed in foster care, have at least one mental health problem. Further, 19 percent of children enter a foster care setting at least in part because of a mental health problem, and with the hope of receiving mental health services. Yet little is known about the outcomes associated with youths who are placed in substitute care settings An initiative supported by the John D. and Catherine T. MacArthur Foundation Knowledge Brief December

2 for reasons other than abuse and neglect. Given the professional training and focus of child protection caseworkers who are concerned primarily with child safety and permanency it is possible that youths placed in substitute care for behavioral problems achieve significantly worse outcomes than those who are placed for reasons of maltreatment. The current study addresses this gap in knowledge, and looks specifically at whether youths placed because of behavioral problems are at increased risk of becoming involved with the juvenile or adult justice system. In doing this, the researchers raise questions about the match between the needs of individual youths and the stated purpose and expertise of child welfare systems. The hypothesis: Youths with behavioral problems will experience more instability and greater restrictions in care, as well as an increased risk of arrest. This brief focuses on three important experiences for youths in care: the restrictiveness of the setting, the instability and disruptions in placement, and arrests (either juvenile or adult). The researchers hypothesized that, because of their behaviors or because of a mismatch with the system, youths placed in child welfare settings for behavioral problems will experience greater instability (movement between homes) and will experience settings that are more restrictive (group homes and residential centers as opposed to a foster family). Both placement instability and restrictiveness are associated with an increased risk of delinquency. Thus they expected youths referred for behavioral problems to be at greater risk of justice involvement, defined here as arrest. The hypothesis emerges from the recognition that child welfare is not specifically designed to address behavioral health or the rehabilitation of juvenile offenders. This creates a mismatch between individual needs, which are largely behavioral, and services, which are oriented more towards safety. This could reasonably be expected to lead to the exacerbation of behavioral problems over time, and eventually to a greater risk of offending. As foster care populations age and state agencies consider broader measures of child well-being, it is more important than ever to understand the relationship between child welfare placements and juvenile offending. Compounding the potential problems of a mismatch between individual needs and service response are the barriers inadequate screening protocols, geographic or financial difficulties in accessing care, lack of evidencebased options that prevent the delivery of specialized emotional and behavioral services in child welfare. In one study of families with open child welfare cases, 40 percent of the children showed a clear need for mental health services but only 28 percent received them. Even when services are provided in the child welfare system, the evidence indicates that very few children receive care consistent with standards proposed by the Child Welfare League of American, the American Academy of Pediatrics, or the American Academy of Child and Adolescent Psychiatry. Problem behavior accounts for a significant proportion of referrals to child welfare. The researchers analyzed child welfare placement data from the state of Washington and matched these records with juvenile and adult arrest data, including both pre- and post-placement arrests. Youths were referred to placement for a variety of reasons, including sexual abuse, physical abuse, neglect, parental substance abuse, child disability, inadequate housing, abandonment, and child behavioral problems. The researchers grouped these into three basic referral categories: abuse/neglect, behavioral problems, and mixed (meaning caseworkers placed children in a substitute care setting for both abuse/neglect and behavioral problems). They then used the pre-placement arrest data to divide each of the three groups according to those who came to child welfare with or without a formal history with juvenile justice. The resulting six categories are seen in figure 1, which shows that 23 percent of youths entered placement for child behavioral problems alone (red bars, solid and striped) and 24 An initiative supported by the John D. and Catherine T. MacArthur Foundation Knowledge Brief December

3 percent enter placement with at least one prior arrest (the three striped bars). Reasons for Placement in Child Welfare Settings Reasons Reasons 5% 10% 9% 23% of youth referred not for maltreatment, but for 14%} behavioral problems alone 10% 52% 0% 10% 20% 30% 40% 50% 60% The researchers found significant differences in the types of settings in which the youths were placed. Figure 2 compares the use of congregate care for youths placed for behavioral problems and youths placed for reasons of abuse and neglect. Only 9 percent of youths placed for abuse/neglect alone (no behavioral problems, no prior arrests) enter a congregate care facility; this contrasts starkly with the 78 percent of youths placed for behavioral problems who are assigned to congregate care. Reason for Referral and Placement in Congregate Care Reasons 42% figure 1 Reasons 43% Youths with behavioral problems experience greater instability and are placed in more restrictive settings. While the primary focus of this brief is on the risk of arrest for youths with behavioral problems, the investigators are also interested in the youths placement experiences. It is generally believed that families are the preferred environments for children. If the child welfare system is indeed a family-oriented system, then youths with behavioral problems should be spending significant periods of time in family settings such as foster care, whether with relatives or non-relatives, rather than in congregate care (group homes and residential centers). Moreover, if child welfare systems are serving youths with behavioral problems at least as well as they do abused and neglected youths, the frequency of changes in placement should be similar for both groups. Yet it turns out that youths placed for behavioral problems are more likely to experience changes in placement than those who are placed for child abuse and neglect: 14 percent of youths placed for behavioral problems change placements at least three times, compared with only 8 percent of youths placed for child abuse/neglect. 9% 17% 76%* 78%* 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% * Behavioral referrals are more likely to experience a restrictive care setting. figure 2 The study also revealed that while congregate care is generally considered a last resort, used only when foster care has failed, youths with behavioral problems are often placed in these more-restrictive settings at the outset and never experience the family setting of a foster home. Youths placed for behavioral problems are at great risk of subsequent arrest. Youths placed for behavioral problems, regardless of prior offending, comprise 23 percent of the sample, yet they account for 31 percent of all arrests. In contrast, youths referred only for physical abuse and neglect issues comprise 62 percent of the sample, yet they account for only 50 percent of all arrests. Figure 3 illustrates the An initiative supported by the John D. and Catherine T. MacArthur Foundation Knowledge Brief December

4 Reasons for Placement and Timing of Arrest Reasons Proportion Arrested Reasons Months between Placement Start Date and Arrest Date figure 3 timing of arrest, by referral group, in the 24 months following the start of their placement. Three items are especially worth noting: Youths coming to child welfare with a history of delinquency (indicated by prior arrests) are at the greatest risk of offending. In fact, the majority of these youths re-offend in a relatively short period of time. Youths entering placement for behavioral problems are at greater risk of arrest than are youths placed for abuse and neglect. Only 14 percent of the youths placed for abuse and neglect alone, with no history of delinquency, are arrested within 24 months of placement. Implications for policy and practice A substantial proportion of youths enter the child welfare system and are placed in substitute care settings for behavioral problems rather than for maltreatment. The researchers found that these youths are more likely to spend time in congregate care facilities and more likely to become involved with the justice system than are youths who are referred to child welfare for reasons of maltreatment. For many of these youths, congregate care is the only placement used to address behavioral problems. These findings raise important questions about how child welfare systems respond to the complex needs of youths with behavioral problems, and whether this type of response is effective. Do child welfare systems have adequate resources and perhaps more important, do child protection caseworkers have the necessary skills and expertise to deal effectively with adolescent behavioral issues? Regardless of the answer, the fact is that child welfare is often the only resource available to vulnerable families struggling with behavioral issues. So rather than debating whether youths with primarily behavioral problems would be best served in other systems, professionals need to engage in the more constructive task of improving services and outcomes for this particularly high-risk population. If we hope to reduce delinquency and arrests among these youths, child welfare systems must begin by limiting the use particularly the long-term use of congregate care. Although such placements offer increased supervision, they are expensive and largely ineffective. A recent study in Los Angeles County An initiative supported by the John D. and Catherine T. MacArthur Foundation Knowledge Brief December

5 found that youths placed in congregate care programs supervised by child welfare were approximately 2.5 times more likely to experience at least one juvenile arrest than were similar youths served in family foster care. If child welfare is going to offer a legitimate alternative to the secure confinement of youths, it must take a more family-focused and community-based approach. From a policy perspective, it is time to consider the child welfare and juvenile justice systems together. Instead of defining each youth as a client of one system or the other, a more effective policy approach would encourage collaboration and the sharing of services, case management, and expertise to serve the unique needs of individual youths. A collaborative approach could be a major step in reducing contact with the juvenile justice system for the large number of youths with behavioral problems placed in the child welfare system. The research described in this brief was supported by the MacArthur Foundation s Models for Change Research Initiative, and was carried out by Joseph Ryan, University of Michigan. This brief is one in a series describing new knowledge and innovations emerging from Models for Change, a multi-state juvenile justice initiative. Models for Change is accelerating movement toward a more effective, fair, and developmentally sound juvenile justice system by creating replicable models that protect community safety, use resources wisely, and improve outcomes for youths. The briefs are intended to inform professionals in juvenile justice and related fields, and to contribute to a new national wave of juvenile justice reform. An initiative supported by the John D. and Catherine T. MacArthur Foundation Knowledge Brief December

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